Heparin-associated thrombocytopenia: a complication of low-dose heparin prophylaxis

The authors describe a 61-year-old white female who received low-dose heparin prophylaxis in conjunction with a radical vulvectomy with abdomino-perineal resection for stage III Bartholin gland carcinoma and subsequently developed heparin-associated thrombocytopenia with thrombosis. This phenomenon occurs in 0.1% of patients exposed to heparin therapy and has been reported as having a mortality rate of 29% and a 21% rate of limb loss. It is thought to be caused by a heparin-dependent IgG platelet-aggregating antibody. Because of the widespread use of heparin prophylaxis in surgery, the clinician needs to be aware of this complication.